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SD CHIP - Application Procedures

To apply for Children's Health Insurance Program (CHIP), you must complete an application and return it to your local South Dakota Department of Social Services (DSS) office. You may complete this form on your computer and print it for mailing, or you may print the form and complete it by hand.

NOTE: A link to the application is available at http://www.state.sd.us/social/Medical/CHIP/Index.htm - or you may pick up an application at your local DSS office.

When completing the application, you must:

·          Send proof of income received in the last 30 days along with the application (current pay stubs, award letters, etc.)

·          Send proof of expenses for child support paid and child care paid while working

If you need assistance filling out the application or have questions, contact your local DSS office. For more information, you can also call this toll free number: 1-800-305-3064.

The start of medical coverage is based on the date the application is received in the DSS office that serves your county. If found eligible. the program may also cover medical services a child received three months prior to applying for CHIP.

See Also:

CHIP - Financial Eligibility

Source:

http://www.state.sd.us/social/Medical/CHIP/Index.htm

Back to:

Children's Health Insurance Program (CHIP)

Office of Medical Eligibility - Overview

South Dakota Department of Social Services (DSS)

Welcome and Introduction to the South Dakota Benefits Information System

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